Scleritis

Question 1

What is scleritis?

Answer 1

inflammation of sclera

Question 2

What is epid for scleritis?

Answer 2

1. Mean age: 40-60

2. Bilateral in 50% of cases

Question 3

What are causes for scelritis?

Answer 3

1. Underlying systemic disorder in 60% of cases
2. Infections e.g. tuberculosis, herpes zoster
3. Idiopathic

Question 4

What systemic disorders can cause scleritis?

Answer 4

1. Rheumatoid arthritis
2. SLE
3. IBD
4. Ankylosing spondylitis
5. Vasculitides

Question 5

What infections can cause scleritis?

Answer 5

e.g. tuberculosis, herpes zoster

Question 6

What are symptoms for scleritis?

Answer 6

1. Dull boring eye pain
2. Eye redness (violet/blue tinge)
3. Over several days
4. Photophobia
5. Lacrimation

Question 7

What is the eye pain like in scleritis?

Answer 7

• May disturb sleep
• Pain exacerbated by eye movements
• May radiate to rest of face

Question 8

What is the key DDx for scleritis?

Answer 8

episcleritis (Also linked to systemic conditions)

Question 9

What is key difference between episcleritis and scleritis?

Answer 9

epi is painless!

Question 10

What is epscleritis?

Answer 10

affects the episclera, the layer of tissue between the surface membrane (conjunctiva) and the firm white part of the eye (the sclera)

Question 11

What investigations are done for scleritis?

Answer 11

Clinical may need to check for antibodies of systemic disease and can do CT/MRI

Question 12

What is management plan for scleritis?

Answer 12

1. Urgent referral to an ophthalmologist (threat to sight)
2. NSAIDs: if mild/moderate
3. Treat underlying causes (high-dose steroids in rheumatological disease and antibiotics for infectious causes)
4. Systemic steroids if necrotising disease

Question 13

What are possible complications of scleritis?

Answer 13

1. Cataracts

2. Permanent vision loss